DESCRIPTION (Applicant's Description) Knowledge building concerning the contexts within which informed decision making and consent take place is critical at a time when the provision of basic medical services, the institution of medicine and the constitution of the hospital are changing. The consequent social, cultural and ethical quandaries that are created by these changes have direct import for the delivery of medical care, the patients' involvement and participation in their care, the promotion of health, the prevention of disease and the advancement of knowledge through medical-scientific research. The first-hand, in-depth observation of the interaction between physician and breast cancer patient within the decision making and consent process will provide 1) the data necessary to analyze this critical process in scientific and medical treatment and research and 2) the knowledge to integrate psychosocial and biomedical concerns with the bioethical issues that must be faced in making life altering decisions concerning cancer prevention, treatment and research. The primary aims of the proposed research will be accomplished through and ethnographic inquiry that will include methods of the in-depth interview and field observation. Breast cancer patients and their physicians will be the participants. The women patients and physicians will come from varied ethnic, age, religious, economic and educational backgrounds. A casebook containing a variety of decision making and consent situations will be developed, based on the data, with the aim of enhancing comprehension and access to information.